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Nature uses fiction to communicate global risks of Avian flu

The 1918 flu pandemic killed 50 million people across the globe. This weeks Nature is devoted to the potential of an avian flu pandemic and contains both news and scientific reports on the subject. To highlight and communicate the risks involved story telling is used in the form of a future weblog, written by a made up freelance journalist.

Repeated warnings about the international community’s failure to respond to the pandemic threat have fallen on deaf ears. So in our opening News Feature, we use the benefit of fictional hindsight to throw the issues into starker relief, describing a future pandemic through the weblog of a journalist in the thick of things. This is fiction, but not fantasy — the storyline was drawn up in consultation with those who could soon be dealing with the situation for real.

Other papers analyses the preparedness and vulnerability of different countries to deal with a potential outbreak and it highlights the large difference in which various Asian countries are handling the situation. It also addresses the role and difficulties of cooperation among international organizations. The stories in Nature provides an interesting case of how the scientific community tries to communicate risks and uncertainty at a global scale.

In the 1918 pandemic, no one had immunity to a new subtype of the influenza virus. The maths of epidemiology says that pandemics are like fault lines: they inevitably give. But unlike earthquakes, pandemics tend to give warning signs, and all the alerts from Asia are now flashing red. Will it be the ‘big one’? No one can say with certainty, but the H5N1 flu strain now circulating widely in Asia, and several of its cousins, are ones to which we humans have no immunity. Accordingly, the world now needs to develop defences for the worst-case scenario. How prepared are we?

Extinguishing avian flu in poultry and pigs, the melting-pot from which a pandemic strain would probably emerge, is the job of national agriculture and veterinary departments, the United Nations’ Food and Agriculture Organization, and the World Organisation for Animal Health (OIE). The public-health aspects are the responsibility of health departments and the World Health Organization (WHO). This international coalition is shaky and far from united or sure in its purpose. Its efforts are grossly underfunded, and undermined at every turn by conflicts between global public health, sovereignty and the stakes of trade and economics.

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Unfortunately, the current situation does not bode well for the abilities of governments and international agencies to cope with this challenge. We should be monitoring in almost real time the genetic changes in the avian and human viruses that could herald the emergence of a pandemic strain, for example. But there is no international funding to help affected countries build decent and sustained surveillance programmes. And while outside researchers want data from affected countries, they aren’t engaging enough in the meaningful collaboration needed to build trust and open sharing. The international community is not offering incentives, such as drugs for the Asian countries that would be in the front line of a pandemic. Combine this with the fact that countries are reluctant to share the few data they have because their analysis could affect their trade and economies, and the current mess in surveillance is hardly surprising.